Have to deal with individual with meds one by one. I agree about the effect some seniors want - like getting a better night sleep having their pain medication at bedtime. I agree about the timed medication dispensing so it is given as intended.
If senior with trouble sleeping, can add 3 mg Melatonin with bedtime medications.
Oh, and ‘sun down syndrome’ - with some it can break through and happen much other times. A very sweet dementia lady was naked and combative the other night. Returned to normal disposition next shifts.
One dementia guy who normally is pretty sweet, was verbally very nasty (way overboard with obscene name calling) and refused to take his medication (which included seizure medication) - and was nasty with 2nd nurse, but a few days out he returned to his sweet disposition and calm behavior. A prior time he needed to go to psych for a while to get ‘adjusted’ because he got physically combative and injured another resident. He has a few demands which was good to know about - having his shades pulled by a certain time, getting his eye drops after his pills (so he could make sure it was correct, even though he never previously really looked at the medication - it was paranoia creeping in).
My dad predictably sundowns in the afternoon. I noted things were better one day when he took a 30-40 minute nap around 1:30. The personal care home has some ideas about some ways they can keep him busy in the afternoon to prevent the agitation. One problem I have with where they are now, nobody has done any sort of planned activity in the afternoon to keep him busy and instead they want him medicated. Hopefully, the “village” at the personal care home, myself, and my husband can do this without medication.
Argh - I just have to vent. It is so hard managing both parents’ lives. I have made appointments (and called for HMO referrals) for the following in the last month: vascular surgeon, cardiologist, PCP, rheumatologist, podiatrist, neurologist, TBI specialist, plus 4 separate bloodwork lab visits and a CT scan. I have to take them to a LabCorp for bloodwork, instead of just having the on site nurses draw the blood.
Now I’m sitting in the ER with dad because somehow when the nurses came to give evening meds he took his meds AND moms. Mom has high BP but dad has low so the doc wanted him under observation in case her heart meds made his heart rate or BP too low.
I have also found two therapists to help mom start to process her grief at the way her life has changed and to learn to deal with my dad’s cognitive deficits. She’s unhappy and knows she is and wishes she were not so I do a lot of validation and active listening with her.
It’s just so hard to deal with such change so rapidly. Plus I had to get my son ready for his first year of grad schoool and my daughter leaves for freshman year next week. At the same time I’m trying to be mindful that my folks are still here and I know someday I will look back and wish for more time with them. So I try to look at all this time spent at doctors or in hospitals as “bonus” time with them.
Yes, life often doesn’t turn out according to anyone’s plan and it is tough to combine many roles. Hugs to you @surfcity, and all that are navigating challenging aging loved ones.
@surfcity-sometimes it is just too much. Super sandwich generation time for you. Good thoughts are going your way.
With elders, this transitional time, where problems are mounting, but are still being addressed pro-actively with medications, lab tests, dr. visits, etc, seems to be particularly taxing on them and their caregivers. For both my parents, at the fork in the “do we keep treating road”, there was some relief. The focus on comfort and not asking more from them also simplified things for me. Of course, one is either in that phase or not. It has its poignancy and grief, yet there is some liberation in it, too. As a hospice Dr said to my terminal with cancer at age 78 mother, “now you can use your energy for what matters most to you: your family and friends.” It truly was quality time.
Medical “stuff” sucks up a ton of energy. My mother ended up with a crazy number of appointments last fall, eye laser procedures, one eye and then the other, each a pre-op, procedure, and post-check for 6 simultaneous with a skin cancer thing, see the PCP, come back for a biopsy, then a referral for a Mohs, have a check, have the Mohs, have the after check, then do another spot, for a total of 8. Ridiculous. She was exhausted and stressed.
I have begun cutting back on checkups, no more mammograms, if they were to find something, we would not be doing anything about it, she’s in her 90s. Fewer other specialists, too. Though the eyes, those are paramount importance, I’ve got three more appointments set up for another eye thing, but that is all about quality of life so it’s worth it!
Yes, I have shocked my sibs by cancelling one appointment for each parent–one was for internist to tell us what cardiologist just told us about mom. The 2nd was just to chat with dad between regular visits–no lab work. Dad wasn’t interested and no one wanted to drive. I didn’t see the point.
Simplifying us a good thing imho. More MD visits is more exposure to sick folks in the waiting room and more pointless spinning of wheels.
Wow surfcity! So much! I hear you. So overwhelming. One thing about my parent’s increasingly advanced dementia is I say “no” to most of the specialist visits. For example, I see no reason for my dad who had a quadruple bypass to have a stress test every 5 years. In fact, no reason to see a cardiologist at all.
Yah, no reason for all the tests and check ups if you would not treat anything found and no reason to risk the massive decline likely to occur with hospital visits and invasive procedures.
Thanks all for your kind words. I just needed to vent to people who understood. I worry my H is getting overloaded from my venting to him sometimes.
I agree with limiting doctor visits, however, mom and dad are actually pretty healthy otherwise, except for the brain injury of dad’s. Mom has recovered from her aorta stent and there is no reason to think they still can’t have a pretty good quality of life (altho less independent) for a number of years. Just need to maintain meds and have periodic maintenance. A lot of the bloodwork was to establish them with new doctors after their move. Dad is doing amazingly well for having T1Diabetes for 55 years - he has no eye/kidney/heart or other issues,
I agree with trying to get people into AL while they are still able to enjoy it - both the fact that many are moving from house to apartment living so many things are taken care of that they used to do and the new social opportunities.
Now that I am going through cleaning up my dad’s stuff, I realize he needed help maybe three years ago. How many unopened letters, not cashed checks (less than $100 worth so far, but still), overdraft notices, subscriptions to crazy newsletters that then I find unopened…
But I’m sure many of you understand that there is such a stress on “he’s an adult, let him live his own life” that maybe we are afraid to take stock. And I have many siblings, most of whom were never involved.
The last AL place we looked at for my dad was monthly rent, many doctors having appointments on-site, and even offered respite care for non-residents for one or two weeks at a time. The place we looked at before, one of my brothers recommended because it looked nice. Residents “buy-in” for $300,000 and most of that is a fee, not for actual real estate. Then a quick search showed how many people weren’t able to get back the 90% of the fee that they advertise.
Surfcity hang in there, and find a little time for yourself and your family. I agree 100% with using your own judgement on the doctor visits - at some point, you lose any benefit if different doctors are answering the same question the same way.
My mother didn’t have the unopened mail (as one example,) was paying her bills, following up on tasks and current events. I was aware of most big medical decisions and agreed with her logic. I thought all that was an example that she was managing, competent. Afterwards, I saw the issues more clearly.
RH, sometimes we can’t tell, in advance. We want to do what’s right. Many of us were influenced by ideas of the superwoman, the professional who juggled all the work, family, and personal balls, looked great, felt great, is perfect.
In many cases, we saw our mothers or grandmothers care for their elderly and we add that expectation. And we expect ourselves to be seers, know exactly what’s going on with them, what’s best, what’s coming next. It’s all huge pressure.
So, RH (and each of you,) it’s ok to not be perfect. These are our parents, but we’re mortal. We do the best we can, at any moment. We need to give ourselves that assurance.
How do folks get parents to stop spending on junk? Dad has become a spending machine, buying all the junk he can, racking up 5 figure credit card debt regularly, promising to stop and then doing it again!?!?!!? I’m sad that all he will be leaving us are unhappy memories and piles of worthless junk that has to be disposed of. They need their money to pay for their care!
The only thing I know to do @HImom is to take away and cut up his credit card. But, it seems the sibling group is too conflicted to stage such an intervention.
We moved the parents this past Thursday from their CCRC to a personal or family care home. They are,of course, confused but no more than I typically see. Nobody seems to be anxious and dad’s agitation seems to be controlled. Mom seems to be benefiting from the social interaction. I do realize it’s only been 2 days so I’m not celebrating yet. I do hope this works. I am enjoying the proximity (1 mile) from my house as it’s easy to “drop by.” I need to bring dad to the clinic to get his tb test read and it’s nice not to have to plan the 1 hour round trip, worry if they have eaten, or concerned they are wandering somewhere. I didn’t realized until now the constant stress and worry I had trying to keep track of them from just 30 minutes away! I don’t know how you long distance caregivers manage!